Concern about the EA London COVID protocol

by Fods123 min read2nd Sep 202112 comments

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As an initial disclaimer, being located in Melbourne Australia, which is currently strict lockdown, I have neither the intention nor the ability of attending the upcoming EA Global London conference. I am also not involved in any way in its organisation, nor am I a public health expert. That being said, like many in the EA community I have been following with unease recent COVID developments, in particular the emergence of the delta strain and resurgence of the virus in places like the UK, US, and Israel. Of particular concern to me are risks such as ongoing spread of the virus from the vaccinated to the unvaccinated, tail risks of 'long covid' symptoms, and the prospect of the emergence of additional novel strains.

Given this background, I was intrigued to see what safeguards were being taken to limit the spread of COVID at the first EA global conference in about two years. Upon reading the EA London COVID protocol, however, I was both disappointed and concerned. I will summarise some of my concerns below.

I find the policy unclear

The first dot point states 'We require all guests to be fully vaccinated', but then according to the second dot point attendees will not be admitted without 'proof of vaccination or an officially logged negative lateral flow test'. So which is it? Do attendees have to be vaccinated, or is a negative test result sufficient?

In other respects I also find the policy insufficiently clear, such as when it states 'we are doing our best to ensure that all vendors and contractors will be vaccinated'. Will vendors be vaccinated or not? I understand this may be difficult to organise, but for something this important a more definite policy seems appropriate. Likewise for the remark 'We are still deciding what to do regarding children'. 

My overall impression is that the policy lacks clarity and cohesion, and does not give the appearance of being as thoroughly considered as I would have expected given such a large and important event in the EA community.

The lack of compulsory masks

According to the World Health Organisation: 'If COVID-19 is spreading in your community, stay safe by taking some simple precautions, such as physical distancing, wearing a mask...' Despite high vaccination rates, COVID is still spreading in the UK. The Institute for Health Metrics and Evaluation estimates that in the UK, universal mask usage by all vaccinated persons would prevent about 8,000 deaths by the end of 2021. 

Given these considerations, why are masks not being made compulsory at the event, at the very least when inside? Even if all guests are vaccinated, they can still spread the virus to other attendees, who can then spread it eventually to unvaccinated persons. The risk is magnified if there are unvaccinated attendees or contractors present. I imagine that the organisers have based their decision to not require masks on some sound basis that I am unaware of (and that is also not explained in the COVID protocol), however in my view requiring masks seems like a very small imposition relative to the potential benefits.

Missing safety measures

There are many aspects of COVID safety that are not even mentioned in the policy. These include measures to promote social distancing, provision of hand sanitising stations, cleaning of public surfaces, or use of QR codes (these are mentioned briefly, but how they will be used at the venue is not explained). While I assume that these measures will be implemented, the fact they are not specified in the policy is concerning.

I find the policy unconvincing

Given these considerations, I do not find the COVID protocol for the EA London event to be adequate or sufficiently reassuring for potential attendees. It lacks even a basic preamble discussing anything about balancing costs versus risks, or a statement that the policy has been carefully developed to ensure the safety of guests and to limit continued community spread of the virus. I assume that these are all the case, but a policy for a large event such as this should in my view make such statements explicitly and back them up with specific details and implementation of best practises for minimising COVID spread.

As someone not directly involved in the conference none of this will affect me personally. Nonetheless, I hope that this article will be of value to those considering whether to attend the event, as well those in the EA community who, like myself, are concerned about the ongoing spread of the virus, and are mindful of what EAs can do to help reduce it.

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provision of hand sanitising stations, cleaning of public surfaces

As I understand it, these two measures are more safety theater than anything else - it seems that almost all transmission is through the air, not through surfaces. But it would be good to hear about ventilation: getting lots of fresh air is one of the most effect ways of reducing transmission.

Finally, I realize this is probably futile given venue restrictions, but as far as I'm aware one dose of J&J is not more effective than one dose of Pfizer or Moderna. If you're going to accept a single shot of J&J, why not also a single shot of Pfizer? Conversely, some other vaccines (e.g. Sinopharm) seem much less effective - does it really make sense to give people full credit for those? Or is there an implicit restriction on which vaccines are accepted based on e.g. MHRA approval?

Thanks for your reply! I've responded to your points separately below:

As I understand it, these two measures are more safety theater than anything else - it seems that almost all transmission is through the air, not through surfaces. But it would be good to hear about ventilation: getting lots of fresh air is one of the most effect ways of reducing transmission.

Great point about ventilation, I've added that to the protocol. See my reply to the OP:

Missing safety measures

The venue does provide surface cleaning and hand sanitizer stations, and we considered including that information in the protocol, but we worried that listing excessive detail would contribute to “safety theater” so we cut it from the final copy. We decided to focus on highlighting the policies that we think are most likely to contribute to safety, rather than giving attendees a false sense of security by highlighting precautionary measures that we think don’t add much. You can find more details on the venue safety protocols here

We failed to mention that the ventilation system at the venue brings in fresh air from outside (rather than recycled air) and has filters that are changed weekly. Windows will be opened to provide additional ventilation where possible (depending on the weather). In addition, the venue capacity is 1,200 in some configurations. We are only having 500 attendees, which is a 23% reduction compared to EA Global: London 2019. I’ve added this information to the protocol. 

Finally, I realize this is probably futile given venue restrictions, but as far as I'm aware one dose of J&J is not more effective than one dose of Pfizer or Moderna. If you're going to accept a single shot of J&J, why not also a single shot of Pfizer? Conversely, some other vaccines (e.g. Sinopharm) seem much less effective - does it really make sense to give people full credit for those? Or is there an implicit restriction on which vaccines are accepted based on e.g. MHRA approval?
 

We discussed this with our COVID Advisory Board, and they acknowledged that vaccine efficacy varies and the data is shifting. But we don’t feel up to doing our own vaccine assessment, and we’ve decided to follow the UK government’s policy here as a bright line.

Great point about ventilation. I am not aware of any evidence that hand sanitisation in particular is merely 'safety theater'. Surface transmission may not be the major method of viral spread, but it still is a method, and hand sanitisation is a very simple intervention. Also, to emphasise something I mentioned in the post, masks are definitely not 'safety theater'. It is good to see that the revised COVID protocol now mentions that mask use will be encouraged and widely available.

Hi James,

Thanks very much for sharing this feedback. 

We mentioned in the protocol that “We considered the venue rules, UK and London requirements, and World Health Organization’s guidelines when drafting this protocol. We also used these resources to draft questions for our COVID Advisory Board.

Some of the complication comes from cases where the rules from these different bodies are different from what our COVID Advisory Board recommended. The various rules and recommendations shaped the policies,  but we didn’t explain our reasoning for some of the decisions and I think some of our language was confusing - sorry about that. 
 

I’ve responded to each of your main points below.


Are negative tests sufficient?

We have updated the protocol to clarify that attendees must be fully vaccinated. To enter the conference venue, they must provide proof of full vaccination. In some cases, the venue might consider the vaccine card inadequate (for example, if the card is from another country without a certified translation). In this case, attendees will also need proof of an officially-logged negative lateral flow test. 

Will contractors be vaccinated?

We’ve requested that all contractors and onsite employees are fully vaccinated. However, the venue expressed concern that they might be prohibited from agreeing due to UK employment discrimination laws, and we haven’t been able to secure agreement yet. We have escalated our request to the venue’s CEO and we’re waiting to hear back. If they don’t agree to fully vaccinated staff, they will require negative lateral flow tests as a minimum.

Can children attend?

We are continuing to monitor the situation and don’t plan to commit to a policy on children until closer to the event. Any parents who might wish to bring their children to EA Global can inform us when purchasing their ticket, and this information will help us to make a final decision.

Why are masks not compulsory?

We may revisit this policy but we’re not currently planning to require masks. We will encourage the wearing of masks and have them widely available onsite but we don’t plan to police their use (and thus don’t want attendees to attend with the expectation of strict mask protocols). The latest Government guidance asks the public to use their own judgement in deciding where they should wear one.  

Missing safety measures

The venue does provide surface cleaning and hand sanitizer stations, and we considered including that information in the protocol, but we worried that listing excessive detail would contribute to “safety theater” so we cut it from the final copy. We decided to focus on highlighting the policies that we think are most likely to contribute to safety, rather than giving attendees a false sense of security by highlighting precautionary measures that we think don’t add much. You can find more details on the venue safety protocols here

We failed to mention that the ventilation system at the venue brings in fresh air from outside (rather than recycled air) and has filters that are changed weekly. Windows will be opened to provide additional ventilation where possible (depending on the weather). In addition, the venue capacity is 1,200 in some configurations. We are only having 500 attendees, which is a 23% reduction compared to EA Global: London 2019. I’ve added this information to the protocol. 

Thanks Amy, I think these clarifications significantly improve the policy. I disagree on the decision not to mandate masks but I understand there will be differences in views there. However mentioning that they are encouraged may be just as effective at ensuring widespread use. That was part of my original concern, that I did not feel this aspect of norm-setting was as evident in the original version of the policy.

Thanks for sharing your concerns. I’ll reply more later (baby is still sleeping on me!) but I wanted to quickly clarify that everyone must be fully vaccinated. The venue may not accept some vaccine cards so the testing backup option is for those limited cases. Sorry that wasn’t clear.

OP's claim of inadequacy of EA London COVID measures lacks an objective "effectiveness" measure. It criticises a lack of clarity of the EA measures  while lacking any clarity itself. 

I am stressing this as this same problem applies to public policy in many countries.  Australia is a severe case: its extremely harsh travel policy seems based on the premise that either the virus and its innumerable variant mutations will simply go away or that Australia can remain in perpetual lockdown without serious negative socioeconomic consequences on the medium and long term. 

For a proper decision (even just at EA Lonon) we would need a collective forecast of the objectively measured number of participants who will be infected/severe cases/die at EA London with the current policy and conditional on the one proposed by OP. Step 2 would be a vote in full knowledge of the forecast consensus and distribution. Prediki Prediction Markt offers free use of its platform for such "effectiveness" purposes. While this would be an effort, it might be well worth it, as a showcase to the world (and Australia) on how to decide such matters objectively and "effectively".

I don't understand how Australia's travel policy is relevant. I'm not asking for anything particularly unusual or onerous, I just would expect that a community of effective altruists would follow WHO guidelines regarding methods to reduce the spread of COVID. I honestly don't understand the negative reaction.

A cynical person might see your post as asking CEA to do extra work for very little potential gain, because most people involved in EA are already pretty careful about Covid. So I guess that's where the negative reaction could be coming from - it sounds like you don't trust individual EAs or the event organizers to e.g. use hand sanitizer unless it's been written down somewhere that people will use hand sanitizer.

Someone in favor of the policy may respond to some of your concerns (e.g. the latter ones) with this sort of argument: https://www.lesswrong.com/posts/6uwLq8kofo4Tzxfe2/long-covid-is-not-necessarily-your-biggest-problem

Worth noting that this evening (6th September) there are reports that a COVID 'firebreak' could be imposed around the time of EA Global London, which could either force the event to be cancelled entirely, or lead to other restrictions being mandated (masks, social distancing, travel). Only tentative rumours so far, but it seems plausible.

Hi Matt. Thanks very much for flagging this. We've seen the reports too and we're developing plans for what we'll do if the 'firebreak' does go ahead. We'll provide further updates as more information becomes available.